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Today, the American Psychiatric Association announced there is enough evidence to support adding Binge Eating Disorder (BED) to the Diagnostic and Statistical Manual.
Why is this so important? The National Institutes of Mental Health estimates that 3.5% of women and 2% of men have BED. Binge eating disorder is more prevalent than anorexia or bulimia. Sixty percent of those with BED are female and forty percent are male, which is the largest category of eating disorders that affects men. Unlike bulimia, those with BED do not have compensatory mechanisms to offset their binging. They do not purge through self-induced vomiting, the use of laxatives, diuretics or through compulsive exercise. BED sufferers share the common co-occurrence of depression, anxiety, bipolar disorder and substance use disorders with bulimia sufferers. Those with BED are usually overweight or obese but not always.
Eleanor is a typical patient I see in my office. She is 35 years old, works at a large company, is unmarried and has been suffering with BED for the past 6 years. She hides her eating because of being embarrassed by how much she eats. However, she has endured "funny looks" by coworkers during work parties in which she goes back to the buffet over and over. She has dieted to try to lose weight but always regains it when her binges begin again. She is embarrassed and ashamed of her behavior but feels unable to control her binging. Her BED contributed to her recent divorce and has made it difficult for her to have close friends. She has been so distraught about her binging that she recently began drinking, which finally led to her seeking help.
Currently, because BED has not had its own diagnostic criteria, most people with BED have not received adequate treatment for their problems. Approximately 1/3 of those going to commercial weight loss centers, for example actually have BED. Weight loss programs are not equipped to handle the emotional aspects of BED. Only about half of those with BED actually have received help with the emotional distress, shame and guilt associated with their disorder.
As well, individuals suffering with BED may not have felt as if their problem was being taken as seriously as anorexia or bulimia. In fact, BED may be more chronic than anorexia (up to 8 years on average).
This historic news may also mean more research dollars can be devoted to the study of BED and hopefully this will lead to more effective treatment and better reimbursement from insurance companies for therapy.
Carolyn Coker Ross, MD, MPH is the author of The Binge Eating & Compulsive Overeating Workbook: An Integrated Approach to Overcoming Disordered Eating.
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